Choledochoscope



June 10, 1952 R. R. ROSENBAUM CHOLEDOCHOSCOPE 2 SHEETS-SHEET 1 FiledFeb. 2, 1950 f g Hepmic Ducis Hepoflc Duct Stones Limlts Common DumIncision "Z0 Poncreus Common Duct Stones June 10, 1952 R. R. ROSENBAUM2,599,662

CHOLEDOCHOSCOPE Filed Feb. 2, 1950 2 SHEETS-SHEET 2 INVENTOR.

Patented June 10, 1952 UNITED STATES PATENT OFFICE 2,599,662onomnoonosooru Randolph R. Rosenbaum, Philadelphia, Pa. ApplicationFebruary 2, 1950, Serial No. 142,040

2 Claims.

about in the tiny ducts. Due to the fact that only a very small portionof the bile ducts may be safely exposed for the purpose of explorationand probing, operations performed under the conventional methods haveresulted in removing between 80 and 90 per cent of the undesirablestones so that the normal operation leaves the patient with 10 to 20 percent of the undesirable stones remaining in the hepatic duct, the cysticduct, or the common duct. Under some conditions, a second operation isnecessary to remove the stones which have not been removed during thefirst operation.

No matter how careful the surgeon may be he is unable to see or feel hisway around the small ducts where the biliary calculi (gall stones) maybe located, so that he is dependent upon his judgement and experience. I

Electra-acoustic devices have been proposed and made to detect andlocate stones in the ducts, but these are expensive and inaccurate.

It is, therefore, an object of my invention to permit visualization ofthe inside of the common bile duct, hepatic duct, right and left hepaticducts and some of the latters branches.

Another object of my invention is to permit the finding and removal ofbiliary calculi (gall stones) in any of the above named ducts.

Another object of my invention is to permit the observation of themucosa lining the ducts for the first time in vivo.

Another object of my invention is to permit accurate location ofstrictures in the ducts.

Another object of my invention is to permit observation, biopsy andtreatment of benign and malignant lesions of the ducts.

Another object of my invention is to permit the visualization and studyof the Sphincter of Oddi and its response to physiological andpathological stimuli.

Other objects of my invention are to provide an improved device that iseasily and economically produced,

fective in operation.

With the above and related objects in view, my invention consists in thedetails of construction and combination of parts as will be more fullyunderstood from the following description when read in conjunction withthe accompanying drawing in which:

Fig. 1 is a view of the ment in place.

Fig. 2 is a fragmentary side elevation of the choledochoscope embodyingmy invention.

Fig. 3 is a front view of the portion of the instrument inserted in thewound.

Fig. 4 is a perspective view of the tip of the in strument.

Referring now in detail to the drawing wherein my invention is shown, Ishow a human anatomy, wherein the gall bladder is shown, the right lobeof the liver is shown, the duodenum is shown, the pancreas is shown, thecommon duct is shown, the hepatic duct stones III are shown, and anumber of duct stones I 2 are shown.

The choledochoscope comprises a tube [4 which is joined at right anglesto a smaller tube l6 having a diameter of approximately 3 mm. On the endof the tube [6 is a lens [8 which enables the viewer to see the interiorof the ducts. At the lower end of the tube I 4 is a mirror set at a 45degree angle to reflect light upwardly. Adjacent the lens I8 is a smallelectric light 20, which is anatomy with my instruconnected to andcontrolled by a rheostat (not shown) by means of the sheathed wires l 9.This light illuminates the area in front of the lens l8. At the upperend of the tube I4 is a lens 22, inserted in a circular lens holder 2|,for the viewer to look through. Hence, the 45 total reflecting prism,24, at the bottom of the tube l4 enables the image from the lens l8 tobe reflected upwardly to the lens 22. Thus the viewer can see theinterior of the ducts.

Adjacent the tube l4 and the tube IE extends a small water inlet tube 26which is adapted to flush and wash away the substances in the duct.

Also adjacent the tube l4 and the tube I6 is a wire, encased in a tube29, which is attached to a flexible forceps handle 28 at one end andwith a pair of fingers 30 extending beyond the lens l8. Closure of theforceps 28 retracts th fingers 30 grasping any small objects near thelens l8.

In application, the shorter arm I 6 is passed into the ducts of thehuman body while the longer tube l4 presents the image up out of thedepths viewers eye. It is to be re- Since the ducts can only beconveniently and safely opened into a relatively small area, as shown inthe accompanying drawing, the choledochoscope is designed to be able togo down into the common duct in one direction, or withdrawn and insertedin a reverse direction to go up into the hepatic ducts. The length ofthe choledochoscopefs lower arm permits completeexamination of theducts.

Althoughmy 'invention has been described in considerable detail, suchdescription is intended as being illustrative rather than limiting,since the invention may be variously embodied and the scope of theinvention is to be determined as claimed.

I claim as my invention:

1. In a choledochoscope, a firsttube having. a lens at one end and areflecting prism at the other end, a second tube joined to said.firstltube and having a lens on one end, a third tube adja- .cent .saidsecond tubefor supplying water j to a location near the lens:on-said1second tube, an

electric-flight adjacent the lens-of; said second -tube :to providelight of awound, and a pair 0f-fleXible forceps adjafor inspecting theinterior cent to said second tube wheseendsare adapted .to grasp objectsnear. the lens on said: second tube.

2. A choledochoscope, comprising a first tube having a lens at one endand a reflecting prism at the other end, a second tube joined to saidfirst tube adjacent said prism and having a lens at its free end, saidfirst and second tubes being at substantial right angles to one another,a third tube adjacent said second tube for supplying water to a locationnear the lens on said second tube, an electric lamp adjacent the lens ofsaid light for inspecting the jacent to said second tube whose ends areadapted -to grasp objects near the lens on said second tube,

and means for actuating said forceps being at- Number tached to andlocated exteriorly of said first tube.

' 1'; RANDOLPH R. ROSENBAUM.

"REFERENCES CITED 'l -he following references are of record in the fileof this patent:

U NITED STATES PATENTS Name CI ,Date ,-Poirier etal .June.,23,:1-903wWappler -May ;6; x1919

